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Level of Anti-FSH and Anti-LH Antibody in PCOS Women And ry & Imm st u i n m o e p h a c t Hussein et al., Immunochem Immunopathol 2018, 4:1 o h o n Immunochemistry & l u o DOI: 10.4172/2469-9756.1000129 g m y m I ISSN: 2469-9756 Immunopathology ResearchResearch Article Article Open Access Level of Anti-FSH and Anti-LH Antibody in PCOS Women and Comparing it with Normal Control Group Shafaq Hussein*, Ihsan Al-Saimary and Maysoon Sherif Department of Microbiology, College of Medicine, University of Basrah, Iraq Abstract Background: Polycystic ovary syndrome is commonest endocrine disorder of female at reproductive age with estimation of its prevalence in general population was 20-33%. Objective: To estimate the levels of Anti-FSH Ab, Anti-LH Ab in polycystic women and comparing it with healthy control group. Patients and methods: This case controls study was carried out in Basrah. In this study blood sample from 29 women with PCOS and 29 healthy control women were collected from outpatient and private gynecological clinics and primary health care centers from different area of Basra from August 2016 to March 2018 for estimation of their serum levels of Anti-FSH Ab, Anti-LH Ab by using enzyme linked immunosorbent assay technique. Results: Serum levels of anti-FSH Ab, anti-LH Ab were elevated in PCOS women. Conclusion: Serum levels of anti-FSH Ab, anti-LH Ab is highly statistically significance in PCOS women than in healthy control group. Keywords: PCOS; Anti-FSH Ab; Anti-LH Ab; Serum levels comparing to normal control group. Introduction Materials and Methods Polycystic ovarian syndrome is a heterogeneous collection of Patients signs and symptoms that form a spectrum of a disorder with a mild A total number of 29 women with PCOS was involved in this case presentation in some women and a severe disturbance of reproductive, control study. Patients where collected from outpatient and private endocrine and metabolic function in others. The pathophysiology of gynecological clinics from different area of Basra regardless the marital polycystic ovary syndrome appears to be multifactorial and polygenic. status, whom age ranged from 20-40 years. The diagnosis of PCOS was Key features include menstrual cycle disturbance, hyperandrogenism based on Androgen Excess and PCOs society at 2006 criteria: and obesity [1]. (1) oligo-and/or anovulation, Polycystic ovaries are commonly detected by ultrasound or other forms of pelvic imaging, with estimates of the prevalence in the general (2) clinical and/or biochemical signs of hyperandrogenism (patients population is 20-33% [2]. presented with hirsute, acne or alopecia, and/or increased circulating levels of testosterone;) and estimation of FSH, LH, prolactin hormone PCOS is characterized by chronic anovulation, hyperandrogenism, in day 3 of the menstrual cycle, and insulin resistance (IR) [3]. Additionally, PCOS is often associated with obesity and a subsequent increased risk for type 2 diabetes [4]. (3) polycystic ovaries (ovarian morphology was assessed using transvaginal ultrasound), The human ovary can be the target of an autoimmune attack in various circumstances, including several organ specific or systemic (4) exclusion criteria. autoimmune diseases. And the presence of a specific antibody is a All patients with hormonal therapy or any medication known commonly accepted marker of an autoimmune disease and serves to to interfere with follicular development or hormonal levels under differentiate autoimmune and non-autoimmune pathologic conditions the study for last 4 months of sample aspiration. All patients with for both clinical practice and further research studies, other pathologies oligomenorrhea, amenorrhea due to other than PCOS causes. involving the ovaries, such as unexplained infertility, PCOS and endometriosis have been associated with anti-ovarian autoimmunity [5]. Beside the confirming of ovarian autoimmunity, anti-FSH antibody *Corresponding author: Shafaq Hussein, Department of Microbiology, may interfere with the endogenous or exogenous FSH function; anti- College of Medicine, University of Basrah, Iraq, Tel: +9647703143884; E-mail: FSH antibody may interact with FSH and form immune complexes [email protected] so provoke its clearance. Also, anti-FSH could interfere with the FSH Received January 09, 2018; Accepted January 24, 2018; Published January 27, binding with its receptors [6]. It was found that autoantibodies to a 2018 specific FSH beta epitope were more prevalent in endometriosis and Citation: Hussein S, Al-Saimary I, Sherif M (2018) Level of Anti-FSH and Anti- polycystic ovary syndrome (PCOS) [7]. LH Antibody in PCOS Women and Comparing it with Normal Control Group. Immunochem Immunopathol 4: 129. doi: 10.4172/2469-9756.1000129 Aims of the Study Copyright: © 2018 Hussein S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits To estimate the level of anti-follicle stimulating hormone antibody unrestricted use, distribution, and reproduction in any medium, provided the and anti-luteinizing hormone antibody in polycystic women and original author and source are credited. Immunochem Immunopathol, an open access journal ISSN: 2469-9756 Volume 4 • Issue 1 • 1000129 Citation: Hussein S, Al-Saimary I, Sherif M (2018) Level of Anti-FSH and Anti-LH Antibody in PCOS Women and Comparing it with Normal Control Group. Immunochem Immunopathol 4: 129. doi: 10.4172/2469-9756.1000129 Page 2 of 4 The control group in women present with ovarian autoantibodies [11]. It is found that administration of therapeutic human gonadotrophin hormones or FSH Consist of 29 fertile women collected from primary health care for induction of ovulation in infertile ladies may induce immunological centers in Basra and who have regular menstrual cycle with no sign of reaction to these therapeutic agents leading to decrease their efficacy hyperandrogenism and their age between 20-40 years and subjected to and induce anti-gonadotropin antibody or anti-follicular stimulating ultrasound examination and have normal hormonal level. hormone antibodies formation and this immune reaction might range Body Mass Index (BMI) was calculated as follows: weight from mild and transient to severe immunological reaction [12]. 2 (kilograms)/height (meters). In this study, 95% of cases had menstrual disturbance, 54% of cases Methods had hyperandrogenism, and 68% of cases had infertility. Menstrual irregularity might be considered as a marker for insulin resistance in Blood sample was collected in clot activator tube, serum was PCOS. oligomenorrhea has been associated with hyperinsulinemia and separated after centrifugation and divided in to two Eppendorf tubes with increased prevalence and future risk of type II diabetes mellitus to avoid multiple freezing and thawing and kept frozen until time of [13]. It is found that PCOS women had infertility rate 66% [14]. analysis to be tested by enzyme linked immunosorbent assay. In the present research it had been found that the mean anti-FSH Results antibody level in PCOS women (lean and obese) is (22.1 ± 39.1 ng/ml) Basic subject characteristics Cases (No=29) Controls (No=29) p Value Age (years) This is a case control study involved 29 patients with PCOS obtained 27.7 ± 5.8 29.4 ± 5.7 0.082 Mean ± SD from outpatient and private clinics in period between August 2016 and BMI(Kg/m2) 27.0 ± 3.4 26.0 ± 3.3 0.060 March 2018. These were compared with age matched 29 apparently Mean ± SD healthy controls. The basic subject characteristics are shown in Table 18-20 years: No (%) 5 (6.8%) 6 (8.2%) 1. There was no significant difference in mean age, BMI or age group 21-25 years: No (%) 24 (32.9%) 13 (17.8%) Age distribution between cases and controls. Around half of the patients 26-30 years: No (%) 17 (23.3%) 20 (27.4%) 0.274 groups (54.8%) have an evidence of hyperandrogenism and only three patients 31-35 years: No (%) 18 (24.7%) 19 (26.0%) (4.1%) have normal menstrual cycle. ≥ 36 years: No (%) 9 (12.3%) 15 (20.5%) Anti-FSH and anti-LH antibodies History of infertility: No (%) 50 (68.5) 0 (0.0%) 0.0 Oligomenorrhea: No (%) 70 (95.9%) 0 (0.0%) 0.0 The levels of anti-gonadotropins are shown in Table 2, there’s no Hyperandrogenism: No (%) 40 (54.8%) 0 (0.0%) 0.0 significant difference in the levels of anti-gonadotropin AB between Table 1: Basic subject’s characteristics. PCOS women and control group. Effect of obesity on anti-gonadotropin antibodies in PCOS No. Mean ± SD Range p Value cases 29 79.6 ± 49.9 (11.6-271.2) Table 3 shows the effect of obesity anti-gonadotropins antibodies Anti-LH Ab 0.051 levels in patients with PCOS. There is no significant difference in the controls 28 101.4 ± 30.1 (74.6-231.5) cases 29 22.1 ± 39.1 (3.5-161.3) level of these antibody between obese and non-obese polycystic ovary Anti-FSH Ab 0.628 women. controls 29 26.4 ± 27.9 (5.9-134.4) Table 2: Anti-gonadotropin antibodies in cases and controls. The effect of hyperandrogenism on study parameters is shown in Figure 1. Hyperandrogenism caused no significant difference in anti- Normal Preobese and Obese p Value gonadotropins antibodies. (BMI ≤ 25 Kg/m2) (BMI > 25 Kg/m2) Anti-LH Ab 1.80 ± 1.70 1.50 ± 1.24 0.553 On the other hand, those with history of infertility had higher Anti-FSH Ab 102.1 ± 68.0 65.9 ± 29.3 0.056 levels of anti-FSH antibodies, but the difference didn’t reach statistical significance (Figure 2). Table 3: Effect of obesity on anti-gonadotropin antibodies in PCOS. The effect of LH/FSH ratio on anti-gonadotropin antibodies in 80 79.8 79.5 PCOS women is shown in Figure 3, there is no statistically significant 70 difference in anti-angiotensin antibodies in PCOS women with LH/ ml 60 FSH ratio more than 3 or less than 3.
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